PATRICIA L JACKSON


Address: 230 W Catalpa Dr, Suite D, Mishawaka, IN 46545-8321
Phone: 5742577551

PATRICIA L JACKSON (NPI# 1376557702) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1376557702
Entity Type Individual
Full Name PATRICIA L JACKSON
Other Name PATRICIA TRETHEWEY
Credential FNP
Practice Address 230 W Catalpa Dr
Suite D
Mishawaka
IN 46545-8321
Mailing Address 230 Catalpa
Suite D
Mishawaka
IN 46545
Practice Telephone 5742577551
Practice Fax Number 5742577535
Mailing Telephone 5742577551
Mailing Fax Number 5742577535
Enumeration Date 2006-07-28
Last Update Date 2019-07-05
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LF0000X Nurse Practitioner
Specialization: Family
71001911A IN Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
IN 200519100 05

Other Providers PATRICIA JACKSON

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1902027329 Patricia Jackson Physical Therapist 307 7th St E, Lehigh Acres, FL 33936-3970 2007-05-02
1396888335 Patricia Ann Jackson Social Worker 420 Mink Pl, Abingdon, VA 24210-3426 2007-02-15
1427132422 Patricia Suzanne Jackson Family Medicine 225 Von Karman Ave, Tullahoma Va Clinic, Arnold Afb, TN 37389 2006-10-25
1710081823 Patricia Ann Jackson Chiropractor 225 3rd St, Batesville, AR 72501 2006-09-11
1073525150 Patricia L Jackson Nurse Practitioner 1252 N 22nd St Unit A, Laramie, WY 82072-5306 2006-08-13
1225094154 Patricia Mcgarvey Jackson Physician Assistant 6800 Southpoint Pkwy, Suite 200, Jacksonville, FL 32216-6257 2006-04-20

Office Location

Street Address 230 W CATALPA DR
SUITE D
City MISHAWAKA
State IN
Zip Code 46545-8321

Providers in the same location

NPI Name Taxonomy Address Enumeration
1598013559 Dung Trina La Pharmacist 230 W Catalpa Dr, Mishawaka, IN 46545-8321 2012-08-24

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1649824103 Senior Helpers In Home Supportive Care 230 Catalpa Drive Suite B, Mishawaka, IN 46545 2019-08-01
1093272114 Candice Marie Greathouse Physical Therapy Assistant 3630 Hickory Road, Mishawaka, IN 46545 2019-02-25
1639662596 Mishawaka Rcf Lp Assisted Living Facility 3630 Hickory Rd, Mishawaka, IN 46545 2018-06-14
1760907299 Timothy John Howard Emergency Medicine 610 1/2 N Main Street, Apartment 1, Mishawaka, IN 46545 2017-08-05
1699203612 Paridhie Vasudevan Dentist 6502 Grape Rd Ste 882, Mishawaka, IN 46545 2017-06-03
1780134650 Ossip Optometry, PC Optometrist 5111 N. Main Street, Suite 200, Mishawaka, IN 46545 2016-10-04
1457730038 Melissa Anne Douthit Nurse Practitioner 3665 Park Pl W Ste 300, Mishawaka, IN 46545 2015-05-28
1558759654 Spine and Joint Associates of Plymouth, Inc Chiropractor 229 Red Coach, Suite 106, Mishawaka, IN 46545 2014-12-26
1609264795 Spine and Joint Associates of Mishawaka, Inc Chiropractor 229 Red Coach Trail, Suite 106, Mishawaka, IN 46545 2014-12-26
1508260795 Maribel Smith Counselor 2989 Heritage Ct, Mishawaka, IN 46545 2014-10-16
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Taxonomy Information

Taxonomy Code 363LF0000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Family

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1467092908 Tori Driver Nurse Practitioner 3005 Grape Rd Ste B, Mishawaka, IN 46545-2709 2020-01-13
1093272593 Regina Lynn Yoder Nurse Practitioner 303 S Main St Ste 111, Mishawaka, IN 46544-2159 2019-02-21
1376021725 Kaley Michelle Marino Nurse Practitioner 1113 Mossy Ln, Mishawaka, IN 46544-9055 2018-07-29
1386192870 Melinda C Nwanganga Nurse Practitioner 4501 Lincolnway E, Mishawaka, IN 46544-4035 2016-09-14
1760835912 Ophelia Ansari Nurse Practitioner 4501 Linconway East, Mishawaka, IN 46544 2016-07-22
1457730038 Melissa Anne Douthit Nurse Practitioner 3665 Park Pl W Ste 300, Mishawaka, IN 46545 2015-05-28
1578692794 Lynn Davis Figg Nurse Practitioner 611 East Douglas Road, Suite 405, Mishawaka, IN 46545-1468 2007-03-05
1467406074 Saint Joseph Regional Medical Center, Inc. Nurse Practitioner 60101 Bodnar Blvd Ste 100b, Mishawaka, IN 46544-9340 2006-05-19
1518955327 Tori Dawn Clabaugh Nurse Practitioner 316 Indian Ridge Blvd, Mishawaka, IN 46545-9034 2005-10-06
1134129919 Jena M Corban Nurse Practitioner 270 E Day Rd, Suite 280, Mishawaka, IN 46545-3444 2005-07-22
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Competitor

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City MISHAWAKA
Zip Code 46545

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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